Post written by Mohammed Barawi, MD, from the Division of Gastroenterology and Interventional Endoscopy, Ascension St John Hospital, Detroit, Michigan.
In this video, we present the case of a healthy 50-year-old man who was seen for routine colonoscopy and was found to have a 7-mm polyp within the base of a diverticulum. The colonoscopy was exchanged, and a single-channel upper forward-viewing endoscope with a band lighting device attached to its tip was used to invert the diverticulum with the polyp and deploy a single rubber band on the colonic wall. The polyp was subsequently resected via hot snare polypectomy at the surface of the diverticulum with an R0 margin and sent to histopathology for further examination, showing a tubular adenoma.
Polyps arising from, within, or near colonic diverticula pose an increased challenge to the gastroenterologist because of increased risk of perforation. Although new techniques have been developed such as endoscopic full-thickness resection, this technique is readily available to gastroenterologists without additional costs or training. Furthermore, the polyp can be safely removed with this technique and sent for further histopathological analysis, in contrast to band ligation alone where the polyp would fall off by necrosis without histopathological evaluation. This technique is safe, readily available, and allows for histopathological analysis of suspicious lesions.
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